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Effect of Structured Perioperative Education on Postoperative Pain Following Lung Cancer Surgery: A Prospective
Anastasios N Moysiadis1, Maria Kalafati2, Alexandra-Stavroula G Nieri2
1Department of Thoracic Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Introduction:
Postoperative pain remains a major challenge after lung cancer surgery and may negatively affect recovery, functional status, and quality of life. Structured perioperative educational interventions may improve symptom management and postoperative outcomes. This study evaluated the effect of a structured educational intervention on postoperative pain outcomes in patients undergoing lung cancer surgery.
Methods:
This prospective, single-center, non-randomized interventional study included 160 patients undergoing surgical treatment for lung cancer between October 2021 and March 2024. Participants were allocated to either an intervention group (n=80), which received structured perioperative education in addition to usual care, or a control group (n=80), which received usual care alone. The educational intervention was delivered preoperatively and reinforced during the first three postoperative days, with caregiver participation encouraged. Pain outcomes were assessed preoperatively and at 1, 6, and 12 months postoperatively using the Greek-language Pain Rating Scale. The primary outcome was current pain intensity. Secondary outcomes included average pain intensity during the previous week, pain distress, and pain-related interference with daily activities. Longitudinal analyses were performed using linear mixed-effects models.
Results:
Significant group, time, and group × time interaction effects were observed for all pain-related outcomes (all p<0.001). Compared with the control group, patients receiving the educational intervention demonstrated significantly lower postoperative pain intensity, reduced pain distress, and less pain-related interference with daily activities across follow-up assessments. The largest between-group differences were generally observed at six months postoperatively. Sensitivity analyses adjusting for baseline pain scores, length of hospital stay, and immunotherapy confirmed the robustness of the findings.
Conclusion:
Structured perioperative education was associated with improved postoperative pain outcomes following lung cancer surgery. Educational interventions incorporating caregiver involvement and reinforcement during the early postoperative period may represent a feasible and low-risk supportive strategy to improve postoperative recovery and pain management in patients undergoing thoracic surgery. Further randomized multicenter studies are warranted to confirm these findings.
